Vitiligoda Dar Bant Ultraviyole B Tedavisine Ablatif Fraksiyonel Karbondioksit Lazer Eklenmesi: Vücut Yarısı Karşılaştırmalı, Prospektif Klinik Çalışma

Abstract

Eşme P., Combining Fractional Carbondioxite Laser with Narrow Band Ultraviolet B Phototherapy for Vitiligo: A Prospective Study with Half-Side Comparison. Hacettepe University Faculty of Medicine, Thesis in Dermatology and Venereology. Ankara, 2017. Vitiligo is a chronic skin disease which is characterized with symmetrical milky white macules and patches. Optimal responses can not be achieved in all patients with narrow band ultraviolet B (UVB) phototherapy, which is accepted as a gold standard therapy. Ablative lasers are used in dermatology for many indications, especially for skin rejuvenation. Postinflammatory hyperpigmentation is an undesirable side effect that can occur after ablative laser procedures. This half-body comparative, prospective clinical trial was designed to test the hypothesis that combination of ablative fractional carbondioxide laser and narrow band UVB in vitiligo may enhance and accelarate repigmentation. Fifty-one (51) symmetrical vitiligo patches of 30 generalized vitiligo patients whose mean was 38.50±12.31 years (range 18-60), who had at least 2 years of disease duration and who has not responded or responded inadequately to narrowband UVB or other vitiligo treatments were recruited for the study. All patients received laser (Lutrionic, eCO₂ plus™, 50-100 mj/cm², 50-200 MTB/cm², 30 watt, 120 micrometer) only to one half-side of symmetrical vitiligo patches with an interval of 2 weeks for 7 sessions. Immediately after laser, patients received whole body narrow band UVB phototherapy (Waldmann UV7001K), 3 times a week. Repigmentation points of laser-added and laser-free patches were evaluated according to photographs which were recorded by digital dermatoscope (FotoFinder Dermoscope™). At the end of the follow-up period, no statistically significant difference was observed between symmetrical patches (p=0,11). Power of this study in excluding this hypothesis was found as 83.3%. Results of this study do not support the hypothesis that combining fractional carbondioxide laser and narrow band UVB phototherapy increases the efficacy of narrow band UVB for vitiligo, with the laser parameters used in this study. Key words: Vitiligo, narrow band UVB, carbondioxide laser, repigmentation Supported by HÜTF BAP Supporting Unit, project no: 6412